A new bend in the road

I feel strangely bereft.  Things have not turned out as I planned.  I am embarking on what seems like a huge responsibility and commitment.  I hope my decision is indeed the best one.  

I always planned to send my daughters to school like any other child here in Ecuador, and intended to teach them English at home so that they learn to read and write the language fluently.  I figured at the end of the day the Ecuadorian children learn to read, write and do arithmetic, and that should be sufficient.  

But then Tamara started school, and it has made me question everything.  I realized they were only teaching her to memorize “facts”, not how to investigate for herself, or assess the accuracy of information.  She was marked down for thinking independently; instead of regurgitating the facts she had been fed.  She was made to feel she was “the worst in the class at colouring,”and no longer wanted to try.  Presentation was all important and the content did not really matter.  The resources were so limited that there was little hands on experience while learning and no IT.  If I left her in school she would be able to function in Ecuador, but be at a great disadvantage should she wish to pursue further studies or a job in Britain at some point in the future. 

There are international schools in Quito – but they are way out of our budget, and would of course require a move and new jobs! 

So that left home education.  

The more I looked into it, the more enthused I became.  I would love to be the one who teaches my daughters.  I already love hearing Tamara read and knowing that it was me that taught her how to do that.  I love sharing a frozen planet clip about penguins with Emily and hearing her telling her granny all about it later.  To be the one who teaches and guides them, helps them to discover new facts and new skills, ensures that their learning is wholesome, important, and diverse – what could be more amazing than that?  And what an exciting age we live in; I have received sufficient education myself to be able to teach them to a high level, and the resources to do so are at my fingertips on the internet.    

So why do I feel so scared and unsettled?  Maybe it is just such a radical change in our lives.  Maybe it is the thought that rather than handing them over to teachers every day… I am now it, for the next ten years or more.  Maybe it is the worry they will be missing out by not having the “normal” school experience.  Maybe it is the worry maybe the girls will get fed up of me teaching them and not cooperate.  Mostly I think it is the fear of the unknown, of yet untested waters, and wondering if it will indeed prove to be a success.  There is a niggle in the back of my mind that says I have let them down in some way. 

But then I come back to the reasons why I have made this decision.  I want my girls to be world citizens.  They have a wonderful life here in Ecuador, and we still have work to do here as a family.  I want them to grow up aware of the many facets of life on this planet, with hearts to take care of it.  I want them to learn to love and serve God and those around them.  I do want them to have the opportunity academically to study the subjects that interest them at the level they wish to, where they wish to.  I believe the best way of combining the precious life experiences that living here gives them, with an excellent academic and personal education is to take them out of school and to teach them myself at home.  

So I will not feel sad when Tamara has her final day at school this week.  I will not think that it is an ending.   Rather I will look forward to the new beginning and exciting world of discoveries and possibilities that lie ahead of us.  

Schools under threat

I first met little Ruth when her mother was expecting her tenth baby.  They made their way down to the health centre on the bumpy milk lorry, setting off early in the morning in order to make it to use before midday. 

Ruth´s mother,  now in her forties, suffered high blood pressure throughout her last pregnancy, and came to us for help.  "I live in a small shack on a farm," she told us.  "The owners let us live there in exchange for making sure no one comes to steal his cattle.  My husband milks the cows, and I look after our nine children.  My husband does not earn much for his work.  We can just about buy enough food for all of us, and I keep a few chickens.  We do not have any money left over to buy anything else.  The house is very small.  We all sleep in just two little rooms.  But at least we have a roof over our heads.  We have no land and nowhere else to go." 

After the birth of a healthy little girl I did not see Ruth and her family again for a while.  It was when I made a trip up to the village that I spotted Ruth playing with her friends outside the village school. 

To get to their village I had to drive along unmade tracks up the mountain side.  There are no buses except at the weekend.  It is very remote.  The school has had the same teacher for several years now.  When you enter the school the children all stand respectfully and I can see that the standard of discipline is high.  The one teacher teaches all the first to seventh year children.  He has about 20 children to teach each year. 

This school is a lifeline for the children who live on these remote farms.  They can walk there each day.  They can study and learn and have the opportunity to find their way out of poverty. 

Ruth now has a sponsor so that she can buy shoes to walk to school in, and the pens, books and paints she needs to be able to study. 

But her school is under threat.  The government has announced any school with less than 30 pupils will be closed. 

20 pupils is not many, but for each of these children the school and its teacher is the difference between continuing a life of hand to mouth exisitence, or of having the opportunity to learn to be a professional and earn a living wage. 

If the school is closed these families will not be able to send their children to school because they do not have the money to pay someone to drive them to the nearest school which takes some 30 minutes in a vehicle. 

I hope the government thinks carefully about the plight of these children, and not just of broad economics, when they take their decisions about the provision of teachers to remote and rural communities. 

Are you up to the challenge?

My own personal journey to becoming a medical missionary began when I finished secondary school and went on a short-term mission team to Ecuador. While we ran a Bible club for slum children a five-year-old boy, Juan, came to our attention. He had a gangrenous finger due to a neglected wound and it had to be amputated. I was shocked. I had seen poverty on the television, but now I was seeing its tragic effects first hand. It was no longer nameless faces suffering; it was happening to my friends.

Jesus’ words ‘From everyone who has been given much, much will be demanded,’ (Luke 12:48) challenged me to consider what I would do with the education, skills and spiritual blessings I had been given so generously. As I looked at the injustice in the world, the sick and suffering who had no doctor to go to, I knew I could not ignore their plight. I felt compelled to go and do something to help, however small it was in the grand scheme of things.

Sorrows
Going to work abroad long term does of course bring with it certain sacrifices. It means living far from your family and distance and time take their toll on even the best of friendships. It may mean missing out on a sibling’s wedding, or not meeting a new niece until she is two years old. There is no big salary or financial security. There are always frustrations to face – obtaining the revalidation of my medical qualifications in Ecuador took a whole year. There are medicines I cannot get hold of in Ecuador that could work wonders for patients; there are patients I could help who prefer to put their trust in the local witchdoctor. Living in an alien culture can be confusing and stressful, earning to communicate in another tongue is exhausting and there are times when you wonder if you’re achieving anything at all – if it is all worth it.

Another challenge is being professionally isolated, sometimes working with local medics whose ethos, ethics and medical practice are very different to your own. Patients die who would undoubtedly have survived had they been in the UK. You need to be able to cope emotionally and spiritually in an alien environment often with little compatriot support.

Joys
But if you ask me if it is worth it I would always, one hundred percent, answer yes. It is worth it when a patient I have been visiting for a year asks me to pray with them, sing them hymns and read the Bible to them on their death bed, commending them into the hands of their Saviour. It is worth it when I can play a part in making the life of a child suffering from AIDS that bit better and see the wide grin on their beautiful face. It is worth it when a patient brings me a (live) chicken to thank me for healing their leg ulcer, and they tell me they give thanks to God.

Satisfaction
Jesus warned us ‘Do not store up for yourselves treasures on earth, where moth and rust destroy, and where thieves break in and steal. But store up for yourselves treasures in heaven, where moth and rust do not destroy, and where thieves do not break in and steal.’ (Matthew 6:19-20) Following the more obvious root of a medical career in the UK may be more financially secure than leaving everything behind and setting off to another part of the world, but I can testify that I have never been in want. I have more than I need.
We live in a world full of people who are suffering and in need. Our God has a heart for the widows and orphans, the oppressed and downtrodden. He hates injustice. Yet in Britain we have 27 physicians per 10,000 population, whereas in many African countries they have less than one. Doctors even come to work in Britain from countries that need doctors far more than we do. We should all consider how each one of us can play our part in loving our neighbour, redressing injustice and reaching out to those in need, including those who live far away. Each and every one is precious to God.

Not everyone is called to serve overseas, but for those who rise to the challenge of long-term mission abroad, you will be embarking on a lifetime of adventure. You will be tried and tested; you will face difficulties and problems. But you will also enjoy moments of great triumph in adversity; you will find great joy as you serve your Saviour. You will see God at work. You will see lives transformed.

published on cmfblog.org.uk  May 2013

Great Expectations

There is nothing like having great expectations.  Today a couple came into my consulting room their hopes built high.  They had heard people have come to me and hence avoided an amputation of their leg, so now that the elderly husband has been sentenced to an amputation they came knocking at my door. 

“Doctor, we have faith in God and after God in you that you can cure my husband´s leg:” Was the opening statement.  “The hospital in Quito wants to amputate his leg, but we know you are going to cure him.” 

“Does he have an ulcer?”  I asked, not seeing any bandages on his leg. 

“No doctor, he has a cancerous tumour in his leg.” 

My heart sank as I knew they were going to be leaving disappointed.  I was not going to be able to give them the hope of a cure they were seeking. 

The elderly man had developed memory loss two months previously, which was why his wife did all the talking.  He had had the growth just below his knee for 8 months.  His wife complained vigorously that her husband had been in hospital for 2 months but that the staff had “done nothing, not even given him anything for his pain.”  Looking at his test results I could see it already had spread to his abdomen.  The man did have a swollen hard area below his knee, but he was very relaxed and not in obvious distress. 

It was one of those moments when I would dearly have loved to be able to see into the future;   to know how aggressive his cancer is going to be, how long he has left and how much distress the tumour will cause him.  The couple face a difficult decision.  The hospital offers amputation as the only treatment.  But he already has spread to his abdomen – and maybe to his brain.  Amputation will remove the tumour in his leg but will not stop the disease that ultimately is going to kill him.  Is this traumatic surgery the best option?  Or will such mutilating surgery be too much for him to cope with? 

I do not know the answer, but I could help them formulate the questions they need to ask themselves and their doctors in Quito.  I could give him some medicines for his pain.  I could not cure the disease, as they had hoped, but I could offer to accompany them along their journey.  I pray the decision they make will be the one that causes that poor man the least suffering possible in the circumstances, and that their faith sustains them in the days to come.     

A month in the life of Andy in the Andes

It is Monday morning and my first patient is Maria: a fifty year old woman who has a diabetic ulcer on her foot.  She was told by the local hospital that her case was hopeless, and that she required an amputation of her foot.  The first time she came to me she was fearful and tearful.  She was terrified of losing her foot and distressed that there appeared to be no alternative.  She needed to be able to walk again, to be able to work again, to be able to provide for her family. 

Today she is smiling.  As we take off the dressings we can see the beautiful red skin growing over and closing the wound.  It is wonderful to be able to help patients like Maria, here in a forgotten village in Ecuador; to show them God´s love by caring for them in a practical manner, and to restore their hope. 

Later in the week I visit Señora Chuba.  She is an eighty year old woman dying of cancer.  Sent home from the hospital with no medicines and no follow up or support, she and her daughter are immensely grateful for our visit.  The nurse and I attend to her physical needs, and then she asks us to read the Bible to her.  We share Psalm 23, pray and sing a hymn together.  Such moments are amongst the most precious in my life.  They are real instants of heaven touching earth.   When her daughter phones me the following day to ask for the death certificate I know that Señora Chuba was ready for her final journey.  

The next week sees me organising a remarkable celebratory meal.  As well as running the village health centre I also run a sponsorship scheme for local children to be able to afford to go to school.  It is the end of the school year and seven girls are graduating from secondary school.  This is an amazing achievement for each and every one of them, and they have each dedicated themselves to their studies in a truly admirable way.  Angela is one of five sisters whose father abandoned them many years ago.  Their mother has worked washing clothes by hand for the neighbours every hour possible to put food on the table.  Sometimes the girls have gone to bed hungry.  They have walked half an hour to get to school in tropical rain storms and blazing hot sun.  Their mother never had the opportunity to study more than primary school.  Angela now has the chance to find a job as a bookkeeper in a local store in the day and to pursue a University course in the evenings.  She can become a professional.  Her life has been transformed by the support of her sponsor. 

Tania has funded her secondary education by participating in our village sewing group.  This afternoon she has brought me her final offering of some intricately embroidered bags.  The money I pay her for them will cover the cost of her graduation.  I am sure these will be a popular item when they find their way on to church stalls in the UK.  Martha has also come with some aprons she has made.  She is deaf and dumb and has not had any education, but she knows how to use a sewing machine really well.  The income from the sewing project enables her to feed and clothe her two young daughters. 

The month ends with my father-in-law´s birthday meal.  He is happily barbequing his favourite meat, guinea pig, while my daughters play and laugh at his side.  The whole family enjoys the special meal and the chance to spend time together. 

This article was published in Life and Work Magazine April 2013

‘Life is but a breath’ – medical mission in Ecuador

‘Life is but a breath’ – medical mission in Ecuador

The importance of Education

Education is so important; essential to be able to achieve your goals and dreams in life.  I was privileged to receive an excellent school and university education in Britain, which equipped me with the skills I can now use in life.  I love the sponsorship scheme of Project Ecuador because it shares this gift of education with so many more children.   

However, sometimes I worry that living in the backwaters of Ecuador my girls will not have the same opportunities as I did.  The level of education in schools is somewhat basic, though they will learn reading, writing and arithmetic. 

However growing up here does have certain advantages too - not least that they are growing up bilingual.  This in itself will open up many doors of opportunity to them in the future. 

A trip to visit a local family on Saturday also got me thinking.  Head knowledge is very important, but moulding a heart so much more so.

The family we visited consists of the young parents, an eight year old girl and a 3 year old boy.  We went as a family to visit them in their tiny wooden shack, which measures 3 by 4 metres.  My girls happily went inside to play with the children, while Vlady and I inspected their small plot and talked with the parents about the possibility of building them a more adequate house.  My oldest, now 4 years old, was full of questions; why the children did not have any toys, why they did not have a bathroom, why they only had one bed.  What an education this is for my daughters as they see first hand how so many people around us live.  In a world gone mad with consumerism they can see how little other children have. Their eyes are open to the great need of our neighbours, and their hearts open to help them.  

I think in the scheme of things a motivated person can learn what they wish to know if they are given the basic skills of reading and writing.  

What a privilege to be able to bring my daughters up also conscious of what it means to live in community and to love one´s neighbour.